The invention relates to a device for the defibrillation of a heart with an implantable cardiac pacemaker and defibrillator, with at least one defibrillation electrode and associated counter electrode, as well as with at least one similarly implantable stimulation electrode, wherein the defibrillation electrode is connected in the position of use to the stimulation electrode, such that the pole of the defibrillation electrode is arranged on the outside of the stimulation electrode.
Such a device is known from practice and is suitable for patients in whom, despite continuously available stimulation, heart chamber fibrillation can occur that must then be immediately counteracted with the defibrillator and the integrated defibrillation electrode.
Because the defibrillation electrode normally has, as a pole, a coil that runs on the outside of the stimulation electrode and because this is often made from platinum, which is a relatively brittle metal that has, indeed, good electrical conductivity but is exposed by the described arrangement to the dynamics of cardiac movements, this can lead to cracks in this defibrillation electrode or its coil, even if this is made from another material, so that its effective length is shortened and is possibly no longer sufficient for defibrillation and the shock required for this.
Indeed, the implanted electrode arrangement could be removed as a whole and replaced by a repaired or new arrangement, but such an operation means too high a risk, in all cases, even for patients who need such a device and electrode arrangement.